Criterios para la selección del tipo de tratamiento quirúrgico en cáncer de tiroides

J. Valls, A. Blanco, Salvador Tabacco, Francisco Tabacco, O. Cabrera, Yeri De Jesus, Yernilex Yareth
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Abstract

Objective: to evaluate the procedure for the surgical management of the thyroid cancer and the criteria for the selection Patients and method: eighteen patients with cancer of thyroid programmed to surgical procedures. Results: the 83, 3% of the series was 45 years or more. No exist T1. Twelve patients were intermediate risk. Radiologic studies and the fine needle aspiration were the methods of evaluation preoperative. Total thyroidectomy was the most common surgery and the histology more frequent was papilar carcinoma. The neoplasies of 4cms or more, the frozen section and the findings in the operating room were be used to adapt the surgical plan in the 66,6% of the serie. Neck dissection was indicated in the clinics lymph nodes. Conclusions: the surgical extension depends of the tumoral size, the presence of cervical metastasis, the infiltration of adjacent structures and frozen sections. The thyroidectomy total with or without lymphadenectomy were the procedures more frequent, other intervention of salvage and palliative intention represents surgical options. The sanitary crisis determinates some problems in the therapeutic process
甲状腺癌手术治疗类型的选择标准
目的:探讨甲状腺癌手术治疗的方法及选择标准:18例甲状腺癌手术治疗的患者和方法。结果:83.3%的患者年龄在45岁以上。不存在T1。12例患者为中度危险。术前评估方法为影像学检查和细针穿刺。甲状腺全切除术是最常见的手术,组织学上以乳头状癌为多见。4cm及以上的肿瘤、冰冻切片及手术室检查结果为66.6%的病例制定手术方案。临床提示颈部淋巴结清扫。结论:手术范围与肿瘤大小、有无宫颈转移、邻近组织浸润及冰冻切片有关。甲状腺全切除术加或不加淋巴结切除术是手术更常见的方法,其他挽救性干预和姑息性意图代表手术选择。卫生危机决定了治疗过程中的一些问题
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